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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by garnet71 on May 25, 2009, at 13:59:21
Low Dopamine causes high prolactin (or is it the other way around). Hypothyroidism can also cause elavated prolactin; as with small tumors on the pituatary glands, which is actually not all that uncommon. There's a field called neuroendocrinology, but I have no idea where these doctors are.
While on SSRIs during the fourth quarter of last year, my motivation slowly dissapeared. During the worst of this last December, when I had no motivation, the back of my head, and from what I saw on diagrams, the cellbrium (thought that doesn't make sense), made all kind of noises; fluid sounds, crackling sounds, and I felt squishy and fluid sensations. This happened all day and night.
When I quit taking SSRIs, this continued, but has slowly disappeared, but my motivation hasn't been the same since. I've never in my life had motivation problems like this, since that last trial of SSRIs. I think the noises and sensations in my brain is a significant symptom, but when i told my endocronologist about it, she didn't even say anything. At the same time, I developed distorted vision; it has not yet gone away. I have seen an opthamologist who gave me a thorough exam, she couldn't see anything as that is not their area; when I told her i was going to the endo, she said that was good. My vision is distorted in that text lines are often bent. at first, and my PDoc confirmed this, I thought it could be related to anxiety. But during the past few months, it has always been there whether or not i had anxiety. I told the endo about this, and it was ignored.
I also had pain in the back of my eye since taking SSRIs years ago, which could not be explained or diagnosed by many specialists, except this one eye specialist who said it was occular migranes, but I think he was full of sh*t because he had no clue what it was and didn't want to admit it. The neuropthamologist, who saw me several times, could not give me a dx. He spent hours talking w/me to try to figure it out. It feels like my optic nerve is being pulled. It comes and goes, hurts so bad I couldn't sleep for a long time period; it hasn't been bothering me lately. I had an MRI, but was so long ago.
Tumors of the pituatary glands and other pituatry problems can cause elevated prolactin and the distorted vision and eye pain; the nerves are pressed. I don't have the sexual/reproductive symptoms that goes w/this issue though.. I think I'm going to go back to the neuroopthamologist again when I get health care.
I think I'm getting really shoddy medical care, and I feel like the only way I'm going to get better is to figure this out myself.
I don't really think I have tumors or some terrible disease, but I think these symptoms are serious. I am wondering how much SSRIs affect the endocrine system, what the hell happened to me, and if anyone sees a link here.
Probably not. lol
Posted by ricker on May 25, 2009, at 15:02:20
In reply to Prolactin - Meds - Dopamine, posted by garnet71 on May 25, 2009, at 13:59:21
> My vision is distorted in that text lines are often bent. at first, and my PDoc confirmed this, I thought it could be related to anxiety.
>That is a common sympton in Macular Degeneration.
You can get a eye chart from most pharmacies, vertical and horizontal line graph, tape it to the wall at arms length, cover one eye and see how distorted the lines are.... they will look wavy.Rick
Posted by garnet71 on May 25, 2009, at 15:12:05
In reply to Re: Prolactin - Meds - Dopamine » garnet71, posted by ricker on May 25, 2009, at 15:02:20
Thanks - i know it isn't that though; my opthm. could tell right away if i had that. They are not wavy; they are bent. like this ^ most of the time, but not when I look directly at something.
Well I hope you are having a better holiday than me!
Posted by ricker on May 25, 2009, at 15:47:40
In reply to Re: Prolactin - Meds - Dopamine, posted by garnet71 on May 25, 2009, at 15:12:05
Hey Courtney,
Just for the fun of it, go to this site and check your eyes on-line using the chart. Simple instructions for the test!
Posted by Phillipa on May 25, 2009, at 18:15:43
In reply to Prolactin - Meds - Dopamine, posted by garnet71 on May 25, 2009, at 13:59:21
Garnet via MRI have microadenema of pituitary gland. No neurologist ever read the films but the radiologists report is in the MRI envelope. Says small don't worry about. Told the endo as have hasimotos thyroiditis and he asked if I lactated as that would happen with pituitary tumors. Blew it off also. This all occurred when had laix prk distance surgery. My taste slowly disappeared and an ENT sent me for the MRI's. So have had it for about six year now. Dont feel it's SSRI related thought could be related to the lasix surgery the loss of taste and smell. Phillipa
Posted by Phillipa on May 25, 2009, at 18:18:30
In reply to Re: Prolactin - Meds - Dopamine » garnet71, posted by ricker on May 25, 2009, at 15:47:40
Hi Ricker no wavy lines for me. Love Phillipa
Posted by ricker on May 25, 2009, at 18:29:07
In reply to Re: Prolactin - Meds - Dopamine » ricker, posted by Phillipa on May 25, 2009, at 18:18:30
> Hi Ricker no wavy lines for me. Love Phillipa
Hi Jan, thats good. I hope you're talking about the eye chart, and not your driving! ;-)
Posted by garnet71 on May 25, 2009, at 19:54:19
In reply to Re: Prolactin - Meds - Dopamine » ricker, posted by Phillipa on May 25, 2009, at 18:18:30
Phillipa,
If you have the resources, you might want to consider getting that treated. It seems the first line of treatment (for tumors?)is currently dopamine agonists:
bromocriptine
pergolide
quinagolide
cabergoline
lisuride...Except bromo was recently deemed or suspected to be unsafe due to heart damage.
You can get permanent nerve damage from them as they press against the nerves (probably also from Lasik). Also-they can cause loss of eyesight.
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The neurotransmitter/neuromodulator dopamine plays an important role in both the central nervous system and the periphery. In the hypothalamopituitary system its function is a dominant and tonic inhibitory regulation of pituitary hormone secretion including prolactin- and proopiomelanocortin-derived hormones. It is well known that dopamine agonists, such as bromocriptine, pergolide, quinagolide, cabergoline, and lisuride, can inhibit PRL secretion by binding to the D(2) dopamine receptors located on normal as well as tumorous pituitary cells. Moreover, they can effectively decrease excessive PRL secretion as well as the size of the tumor in patients having prolactinoma. Furthermore, dopamine agonists can also be used in other pituitary tumors. The major requirement for its use is that the tumor cells should express D(2) receptors. Therefore, in addition to prolactinomas, targets of dopamine agonist therapy are somatotroph tumors, nonfunctioning pituitary tumors, corticotroph pituitary tumors, Nelson's syndrome, gonadotropinomas, and thyrotropin-secreting pituitary tumors. It is also an option for the treatment of pituitary disease during pregnancy. Differences between the effectiveness and the resistance of different dopaminergic agents as well as the future perspectives of them in the therapy of pituitary tumors are discussed.
Posted by garnet71 on May 25, 2009, at 19:59:19
In reply to Re: Prolactin - Meds - Dopamine » garnet71, posted by Phillipa on May 25, 2009, at 18:15:43
Phillipa, Do you know-does the MRI have to be ordered a specific way to look for this?
Garnet via MRI have microadenema of pituitary gland.
Posted by garnet71 on May 25, 2009, at 20:00:30
In reply to Re: Prolactin - Meds - Dopamine » garnet71, posted by ricker on May 25, 2009, at 15:47:40
Ricker, I have one of those charts, thanks for the online link. I can assure you I have phenominal eye doctors! Wish all my doctors could be like them.
Your posts are always very helpful--thank you.
Posted by garnet71 on May 25, 2009, at 20:04:08
In reply to Re: Prolactin - Meds - Dopamine » Phillipa, posted by garnet71 on May 25, 2009, at 19:54:19
I made a mistake--it was pergolide that was deemed unsafe; i think it was just taken off the market.
From Wiki:
The drug is in decreasing use, as it was reported in 2003 to be associated with a form of heart disease called cardiac fibrosis.[2] This problem is thought to be due to pergolide's action at the 5-HT2B serotonin receptors of cardiac myocytes, causing proliferative valve disease by the same mechanism as ergotamine, methysergide, fenfluramine, and other serotonin 5-HT2B agonists, including serotonin itself when elevated in the blood in carcinoid syndrome. Pergolide can rarely cause Raynaud's phenomenon. Among similar antiparkinsonian drugs, cabergoline but not lisuride exhibit this same type of serotonin receptor binding.[3] In January, 2007, cabergoline (Dostinex) was reported also to be associated with valvular proliferation heart damage.[4] In March 2007, pergolide was withdrawn from the U.S. market due to serious valvular damage that was shown in two independent studies.[5]
Posted by Phillipa on May 25, 2009, at 20:42:01
In reply to Re: Prolactin - Meds - Dopamine » Phillipa, posted by garnet71 on May 25, 2009, at 19:59:19
Garnet are you saying you also have a microadenoma of pituitary gland. Just was an MRI of pituitary gland. I'm not worried about it from googles seems they don't treat them and surgery is what's used. Phillipa
Posted by Phillipa on May 25, 2009, at 20:43:30
In reply to Re: Prolactin - Meds - Dopamine » Phillipa, posted by ricker on May 25, 2009, at 18:29:07
Rick hope just the eye chart as have been know quite frequently to stay to far on the right side of the road. Love Jan
Posted by garnet71 on May 25, 2009, at 22:20:44
In reply to Re: Prolactin - Meds - Dopamine » garnet71, posted by Phillipa on May 25, 2009, at 20:42:01
No-not necessarily; but there has to be a reason for my vision problem. Wondering if an MRI I had a few years ago would have picked up something like that, that's all...
There's some psych drugs in this list that cause hyperprolactinemia...
http://www.reuniting.info/science/prolactin_hormonal_politics_jeremy_heaton
TABLE 2
Causes of hyperprolactinemia
βΆ Spurious (macroprolactinemia)
βΆ Central nervous system
Pituitary tumors
(PRL, GH, ACTH, nonsecreting)
Stalk effect
Hypothalamic tumors
Granulomatous disease
Pinealoma
Aneurysm
MeningiomaβΆ Medications
Histamine blockers
Metoclopramide
Neuroleptic agents
Estrogen
AmitriptylineβΆ Primary hypothyroidism
βΆ Chronic renal failure
βΆ Chest trauma
βΆ Stress
βΆ Other
Posted by garnet71 on May 25, 2009, at 23:12:29
In reply to Prolactin - Meds - Dopamine, posted by garnet71 on May 25, 2009, at 13:59:21
Well I guess there might be some evidence SSRIs can cause hyperprolactinemia:
http://www.nature.com/npp/journal/v29/n5/abs/1300412a.html
The widespread use of the selective serotonin reuptake inhibitors (SSRIs) has been accompanied by numerous reports describing a potential association with hyperprolactinemia. Antipsychotics are commonly known to elevate serum prolactin (PRL) through blockade of dopamine receptors in the pituitary. However, there is little awareness of the mechanisms by which SSRIs stimulate PRL release. Hyperprolactinemia may result in overt symptoms such as galactorrhea, which may be accompanied by impaired fertility. Long-term clinical sequelae include decreased bone density and the possibility of an increased risk of breast cancer. Through literature review, we explore the possible pathways involved in serotonin-induced PRL release. While the classic mechanism of antipsychotic-induced hyperprolactinemia directly involves dopamine cells in the tuberoinfundibular pathway, SSRIs may act on this system indirectly through GABAergic neurons. Alternate pathways involve serotonin stimulation of vasoactive intestinal peptide (VIP) and oxytocin (OT) release. We conclude with a comprehensive review of clinical sequelae associated with hyperprolactinemia, and the potential role of SSRIs in this phenomenon.
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